Table 1.

Teaching points

1.Arginine vasopressin deficiency (AVP-D), formerly known as central diabetes insipidus, can present with atypical signs and symptoms. Comprehensive assessment of the pituitary-adrenal axis is crucial.

2.In the presence of panhypopituitarism, AVP-D can be unmasked by high-dose glucocorticoid and is characterized by sudden onset polyuria, polydipsia, and mild hypernatremia.

3.Temporary interruption of vasopressin therapy should be considered in patients with CNS lymphoma with AVP-D, particularly during high volume fluid administration (e.g., sodium bicarbonate infusion after high-dose methotrexate).

CNS, central nervous system.